Individual provider Active NPI

Asisan Kalsi, DMD

  • Dentist
  • Kennewick, WA
National Provider Identifier
1710613484
Registry record updated Jun 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DE61319641 Issued in WA
Practice address
216 N Edison St
Kennewick, WA 99336-1956
Phone
(509) 737-0327
Fax
(509) 737-1360
NPI assigned
Jul 26, 2022
Last updated
Jun 28, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DE61319641 WA Primary

Addresses

Primary practice location

216 N Edison St
Kennewick, WA 99336-1956

Mailing address

2611 S Quillan PL Ste 110
Kennewick, WA 99338-1899
Phone (509) 585-5437

Other practice location 1

2611 S Quillan Pl Ste 110
Kennewick, WA 99338-1899
Phone (509) 585-5437

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230710003654 WA Order and Referring Only - DentistPractitioner - Dentist 7315306271

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Creekside Dental Sleep Therapy PLLC Dentist CurrentSince Jul 31, 2022 Accepting new patients
Csdental, PLLC PastSince Jul 31, 2022 Accepting new patients

Locations

216 N Edison St
Kennewick, WA 99336
Phone (509) 737-0327

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1658793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687910400000",
    "number": "1710613484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2611 S QUILLAN PL STE 110",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993381899",
            "telephone_number": "509-585-5437",
            "fax_number": "509-545-5438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 N EDISON ST",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993361956",
            "telephone_number": "509-737-0327",
            "fax_number": "509-737-1360"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2611 S Quillan Pl Ste 110",
            "address_purpose": "LOCATION",
            "city": "Kennewick",
            "state": "WA",
            "postal_code": "993381899",
            "country_code": "US",
            "telephone_number": "509-585-5437",
            "fax_number": "509-545-5438",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KALSI",
        "first_name": "ASISAN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-26",
        "last_updated": "2023-06-28",
        "certification_date": "2023-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE61319641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennewick, WA

Sources for this page

Verify at the official NPI Registry.